How much rates vary
Facilitymedian $1,096 · 10th to 90th $437 to $8,511Professionalmedian $1,413 · 10th to 90th $135 to $2,291
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,659.59 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,659.59 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,659.59 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $1,778.28 | Professional | None | $239.88 | $239.88 | $1,778.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,659.59 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,659.59 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $3,801.89 | Facility | None | $1,096.48 | $1,659.59 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,778.28 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,258.93 Typical High $2,290.87 | Professional | None | $123.03 | $1,258.93 | $2,290.87 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,621.81 | $2,818.38 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $1,148.15 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $891.25 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $870.96 | $891.25 | $1,230.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $354.81 Typical High $489.78 | Professional | 80 · Assistant surgeon | $346.74 | $354.81 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $251.19 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $245.47 | $251.19 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $251.19 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $251.19 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $251.19 Typical High $338.84 | Professional | AS · PA/NP assist | $245.47 | $251.19 | $338.84 |
Where South Carolina sits
The same service costs 13.5 times more in Maine than in Washington. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $28,253WA $2,096
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.